Help! Pain, status post bunionectomy and Lyrica

Four weeks ago, I had a bunionectomy with placement of two screws. Progress has been very slow, I believe, but according to the doctor, I am on track.

The before and after x-rays are amazing, restructuring of the bones of foot, and the huge bulge shaved off.

Looking at the x-rays, one would think I would have pain at the site of the two screws....they don't look comfortable in their position on the film.

Nope, I have SEVERE pain in the left upper corner of my big toe nail.....the site of where an ingrown toe nail would be. It feels as though someone took a pair of pliers and pulled the tissue under the nail beyond the end of my foot, then over the top, and then down my foot. Moving the toe forward and back helps the pain. The pain is spontaneous... or sometimes is brought on if I am moving my leg.

The doctor pinched the area, that did not hurt me any more. There is no redness at the site, no obvious site swelling.

The first few weeks after surgery my foot including my toe was swollen, therefore I thought the problem was the nail cutting into the swollen toe, now, the swelling is down.

The doctor shock his head, he had NO answers, NO clue. He thought the pain might be nerve so prescribed Lyrica. After he made that decision, he noted the history in my chart again... checking allergies, and noticed the diagnosis of fibromyalgia...he had not remembered. But said, well, we may be on the right track given the fibromyalgia.

I have a week's free trial, read the side-effects and am very fearful of taking it. My husband ran the free trial offer into the drug store and spoke to the pharmacist to be sure this would be safe for me to take, and his only caution was with the Vicodin, it really could make me groggy. I would not take both of them, I do not take the Vicodin much now, weaned it down. I only need it for the "toe nail" pain.

Anyone have any experience with Lyrica for "nerve" pain similar to this???? Also I would be interested in your response on Lyrica not matter why it was prescribed. What if any were your side effects.

I did a search, spent some time reading through the posts but was not finding the info I needed.

Poor June! I have a friend who had the same thing done (both feet!) last summer and it was a long, long slog to recover.

I think that topical capsaicin (that which makes hot peppers hot) might help you if the pain you are feeling is from a nerve and it certainly sounds like it could be. I use topical capsaicin for Trigeminal Neuralgia and it is amazing.

Capsaicin disables the nerves ability to transmit pain by depleting it of something called "substance P" which is necessary for pain transmission. The heat of the capsaicin keeps the nerve pumping out p until it's all used up. The nerve still functions normally in every respect except transmission. And, unlike the face, there's not too much danger of getting the "hot pepper" into sensitive areas like your eyes - which I have done more times than I care to remember.

You might want to google the nerves of the foot and see if you can trace back from the sight of your pain along the path of a nerve and treat the entire path but it may be enough to simply treat where you feel the pain.

I hope this helps!!!

ETA I use Zostrix HP which is available over the counter and a tube would last you a long, long, long time.

I have always had horrible bunions but since they never caused me pain I did not seriously consider surgery. I dream of beautiful feet in slim, flirty sandals! Oh, also my lost youth.

I have used Lyrica. It was prescribed for pain by my pain doctor. I am generally able to take normal doses of all medications. In that I am not your regular ME/CFS plus fibro patient.

It was originally prescribed to be taken for pain in the early evening - I think it was two 75 mg capsules. I needed something else for pain to help me stay asleep. I have a brain tumor that causes Trigeminal Neuralgia, Fibro and a cervical spinal cord compression injury. Of course I also have ME/CFS/Fibro. All cause nerve pain so the Lyrica seemed like a good choice and I took it regularly but not every night. It made me so sleepy I was falling asleep sitting up.

For a long time I thought it was great just because I had no trouble falling asleep but it did not keep me asleep and so I had to keep taking Lunesta for sleep. Other than sometimes feeling groggy when I woke up in the morning I was okay with it. The combo had me sleeping 8 hours with out waking up every 2 hours to go to the bathroom! But once I woke up in the night only partially and was fighting for consciousness and struggling to breath. I told myself it was one of those weird sleep things we poor sleepers occasionally get; sleep starts; sleep paralysis; jumping legs, etc. I kept taking it until I had another episode where I had to fight to both breath and wake up. Although I no longer take it I do credit the combo for breaking my insomnia. But it just really puts me too far under. I couldn't tell you if it worked for pain because I wasn't awake long enough to find out! If you try it for daytime pain I would start at the lowest dose, avoid napping and try it only if you don't take other medication.

The pain is big time pain and from the doctor's office we went right to the drug store, and my husband hoffed it into the pharmacy. I was done using the crutches for the day.

Riddle: Why do they put pharmacies all the way to the back of the store???? So we will compulsive shop on our way to the back of the store or out again. Well, maybe this is not a riddle if a riddle is supposed to be funny.

I KNOW those patient information sheets go into the very last side effect, yady, yady, yady. But I have been at this for 30 years and initially my rheumatologist tried hard to "fix" me or at least help with the pain and we tried many different things. But, alas, what I learned about myself was the less --- the better.

I like your idea of a topical agent to see if that helps first, before I put something in my mouth that will affect my entire body.

My husband is taking me to get my haircut this afternoon, will put up the capsaicin then. Also will try to apply the nerve root application however, my incision may interfer with that as it runs along that side of my foot from the middle of the big toe to my ankle.

I am going to try a topical agent first, (see above) but I also need the information you gave me in your post if the capsaicin does not work, thank you so much.

If I understand correctly, I will get some relief with the first pill I take? The med does not have to build up in the body? Do I have that right?

If that is the case, I would feel a bit better about trying it. I question any new medication now. Help with the sleep would be great. I am not a great sleeper, often wake up in the middle of the night. But it has been so much worse now, because my foot is waking me up. The doctor did caution me to take it at night because "it probably will put you to sleep." My husband who must drive me everywhere, was in the examining room with me and replied. "The couch puts her to sleep." Doc replies surprised but laughing, "my couch puts me to sleep also." We agreed we both had "couch syndrome."

When he had checked my chart as he was writing out the script for the Lyrica, and at that time noted the FMS on my history which triggered his memory I had FMS, he said, "well, you know much more about fibromyalgia than I do. "

That statement was okay with me. He did not try to flub his way through the scene. He just put the fact out there.
Thank you for replying to my post!

It sounds like it, June. Not good! Capsaicin is good for "big time pain". In studies they have used it for neuropathic pain which did not respond to anything including opiates and it worked. It's so mechanical in its actions -- no substance P, no ability to transmit pain. Trigeminal neuralgia is affectionately called: the suicide pain. After tegretol and neurontin failed, capsaicin rid me of it. Now, all I need is to apply a few times every several weeks. It's a miracle. I SO hope it works for you!

I like your idea of a topical agent to see if that helps first, before I put something in my mouth that will affect my entire body.

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Yeah, for sure, and also something that is appropriate for big time pain!

Also will try to apply the nerve root application however, my incision may interfer with that as it runs along that side of my foot from the middle of the big toe to my ankle.

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Oh dear! That is a complication! have you looked at where the path of that nerve is? It may take another route. I sure hope it takes another route!

You have to give it a little time to work. Took about 3 days to deplete my trigeminal nerve and I was applying like a woman posessed. Do follow all package instructions! Don't get it in your eyes or other sensitive areas - if you know what I'm saying :worried: So not fun!

I'm going to go google nerves in the foot that lead to the point of your pain.

Ok, it seems to be the medial plantar nerve which runs along the top of the foot!

I would be careful to ensure it doesn't melt over into your incision, though. Not too hard to ensure, I wouldn't think, unless you have sweaty feet. Also, don't let water spill over from capsaicin area to incision but you probably can't get incision wet anyway.

Still have all eyes crossed!

ETA Given the extent of that nerve and the fact that you have pain only in the inside of your toe, you could probably just apply to inside of toe and a little bit onto foot. That would probably do the trick!

Thank you. As the pain is on the top of my foot, I would need to place the capsaicin on a dorsal nerve/root, not the plantar surface. Those are great images, by any chance do you know which website you found them?

I am four weeks status post surgery, so I can get my foot wet and started soaking the foot to help remove the dead skin that has been sloughing off.

Yesterday, I used a warm water soak. I was afraid that little bit of heat might inflame things a bit, so I finished off with an ice pack on the top of my foot. Afterwards, I noted the bottom of my foot felt better, muscles more relaxed, it was better than it felt in awhile.

I have only been able to do heel strikes and yesterday mentioned to the doctor I felt the heel strikes, being such an unnatural position for the foot, was aggravating some of my pain, contracting the muscles on the bottom of the foot. He agreed to that theory and said I could put my foot down flat, but only put five to ten pounds of pressure on the foot. Geezzzz my foot probably weighs five pounds.

Koan, wanted to thank you for your advice on using Capsaicin for nerve pain status post bunionectomy. It helped. As I have so many side-effects from meds, I was relieved not to have to take the Lyrica.

Thank you for taking your time and energy to reply to my request.

June

PS, I tried PM'ing you first as I wanted you to know how grateful I am and was afraid you would not be back to this thread, but received a message your mailbox was full,

In fact, it works so well that I think I have an abscess on the side of my face I treat with it but there is little, to no, pain because I used capsaicin! When using for TN you have to make sure you take care of your teeth because you won't necessarily be able to feel pain when there's a problem!

I just love how simply mechanical the effect is!

Anyway, I'm so happy it helped. The more you apply, so long as you allow sensation of heat to fade before reapplying, the more unable the nerve will be to transmit pain so don't suffer along with any residual pain if you don't have to!

said I could put my foot down flat, but only put five to ten pounds of pressure on the foot. Geezzzz my foot probably weighs five pounds.

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IntuneJune, Thanks for the laugh. Please believe me, I don't belittle your situation at all. I had a friend go through that surgery, and I've heard it's very painful. But I'm picturing you (well, myself, really because I don't know what you look like) trying to gauge just what exactly is 5 to 10 pounds. Now, would that be a step, then a short and very light hop with the bad foot? I would think a crutch would be necessary. Anyway . . .

Yes, capsaicin is a very good pain reliever for a localized area. No doubt about it. But I just want to say that I've been taking Lyrica for fibromyalgia pain since it was approved, without any problems except a little weight gain. Just 2 (75 mg.) tablets a day are very effective. The first one I take in the A.M. with coffee to ward off any drousy effects. The other closer to bedtime because I read it enhances slow wave sleep.

Yes, I am using crutches. Surgery was six weeks ago tomorrow. Six week on crutches. At first, it was all about the foot, geezzz it was so swollen and painful. Instructions were to keep elevated above the heart. That meant flat on my back to keep the foot higher than the heart. I constructed a "tower of pillows" to keep my foot that high. Compliance was easy. Any time the foot was lowered, it throbbed with pain.

Trips to the bathroom were not fun either, I was not allowed to bear any, ziltch, nada, no weight on the foot.

And briefly to explain the foot. My incision went from the middle of my big toe to almost my ankle. There was a sterile gauze pad over the incision. There was a big bulky fluffy gauzey wrap/pad over that. Next, ten feet of narrow, stretchy wrap that circled my foot, wound around my ankle in a figure of eight fashion, back down to my foot circling again a number of times. (OK, that was the ONLY exaggeration so far, it was five feet long.) Now the boot. The boot has two parts, a soft inner and hard outer. The soft inner part velcroed shut with small strips. The outer velcroed shut with long long velcro straps. AND what does velcro do????? It sticks! Getting the soft part of the boot on my foot was alright. But then getting the my foot into the hard shell was impossible, the inner boot kept getting caught in all the wrong places and I could not get it into the shell without a fight. (Why not leave the inner part in the boot in the first place???? my foot was so swollen and painful, I could not get it out of both parts at once, had to do this in stages.)

Ta.....dah!!! Boot on, ready to head to the bathroom.

Learning to maneuver with crutches at my age, not easy. Use your imagination on this one,

Arrive at destination..... Ummmmmm...... Lowering one's butt to the toilet using only one leg, impossible. Try it! No cheating. This is a one-legged squat to the level of a toilet seat. And when arriving safely on the "throne" remember your foot is now throbbing with pain, well, you should feel pretty proud of yourself, you did arrive safely without breaking you or the throne!!! Good!!!

Oh no.....good not for long...... it is getting up time...... (it really is easier going down). ####Why was it not suggested to me I MIGHT need one of those gadgets over the toilet to assist?????#### There is nothing to hang onto, no way to push off. This is where you really are allowed to use nasty words!!!

Next, upright and sweating and panting.....wash hands. Foot throbs more, d___, where did that hand towel go???? Oh geezzzz, one of the crutches fell..... More nasty words allowed.

Hobble back to bed, breathing hard. Sit on bed, stack the "tower of pillows" just so..so the pillows will stay put and not tumble apart. Get the hard plastic part of the boot off....very awkward this boot... foot throbbing....maybe just leave the darn thing on, then ...on your mark...get set...go and swing that contraption up on the pillows.... now get it centered...oh, the middle pillow is slipping, straighten that out, ok...now place the ice pack on if you took the outer shell of the boot off.... lay back down making sure the hips are not too close to the "TOP" or too far away which would cause knee or hip strain. Get the pillow under the head. Comfy????? Great!

Now back to the book I was reading, oh, where IS the book I was reading.... there is it on the wheeling table which is right next to the bed unless it gets moved when I have to get up and now.....it is out of reach.

That was my first two weeks.

On a more serious note, mobility on crutches is curtailed because of the fibromyalgia. Thank goodness, here on this forum, I need not explain why I using these things plays havoc with the rest of the body.

I am sorry to hear of the pain issues you have been having since your bunion surgery and have been interested to read this thread.

I was due to have an osteotomy (bunion surgery) done a couple of weeks ago and cancelled it one week prior, because I felt uneasy about the surgery with having Fibromyalgia. Was particularly concerned about whether I would be going 'out of the frying pan into the fire' in regards to ongoing pain. I then consulted with my Podiatrist two weeks before the scheduled surgery (independent opinion) because of this unease I was having and he said that altho' the bunion was very obvious, I actually had good joint movement at the base of the large toe - so I had good push off when walking. He said that to mess with this may change the way the hip and knee joint are able to subsequently respond to walking (biomechanics). As I have enough pain in the hips and knees I thought I'd leave it for the time being. I also have significant amounts of neuropathic pain also to take into consideration.

I'm pleased now that I made this decision to cancel and will wait and see what the future brings.

I hope that you start to get some relief from this unexpected side effect that you have had following your bunion surgery.

Now weeks later, I am much better than the post above. That did go on for two weeks, also I had the nerve pain which finally stopped. Now I am six weeks postop.

Thirty years ago, I was sporting impressive bunions. My hips and back hurt before that. I also wonder what effect this surgery is going to have on my knees, hips and back. Hopefully, it will be for the better.

What happened over the past year and a half brought me down..... Shoes had always been a problem , but now impossible and very painful. Also, the lack of support directly in front due to the positioning of the big toe so far to the side resulted in balance problems.

My putting the surgery off then resulted in having a more complicated surgery requiring two screws to keep the bones in their new and correct position.

If I were younger, life on crutches would probably be a little easier. Recuperating from surgery at a younger age is usually easier. And if I had not put surgery off, I would not have needed the more complicated procedure.

June, I too felt it was better to have my bunion surgery done now before it got too severe and before I got older - however it can wait a bit longer now I'm sure. My sister (early 50's) waited too long and she had to have quite radical bunion and toe reconstruction surgery like you to fix hers. However she doesn't have ME/Fibro so she had no post-operative pain. Lucky her!

Francelle;61441 ]June, I too felt it was better to have my bunion surgery done now before it got too severe and before I got older - however it can wait a bit longer now I'm sure.

I wish my scanner was working. The surgeon gave me copies of the before and after x-rays. Even though my foot looked bad, I did not realize the damage I had done to my foot by waiting.

My sister (early 50's) waited too long and she had to have quite radical bunion and toe reconstruction surgery like you to fix hers. However she doesn't have ME/Fibro so she had no post-operative pain. Lucky her!

I am wondering if the nerve pain was directly related to fibro... because of our abundance of substance P. The topical capsaicin helped, and the doctor gave me pain meds which helped. I did not go on to take the Lyrica.

I hope that everyday your pain and mobility is improving!

Thank you, I have no pain now, but still am nonweight-bearing. I will probably hear from the foot once it is in action again. Francelle, if anything, I never want to encourage anyone to go under the knife, but putting this off was one of my WORST decisions in life.

Alas, we have two feet, and my other foot looks exactly like this one did.

The End Fatigue Pain Formula is a fantastic herbal mix that in research studies has been as effective has Rx pain meds. I use it for all types of pain: http://fibromyalgiafatiguesupplements.ecrater.com/product.php?pid=7414762 . Take 1 tablet three times daily. May increase to two tablets three times daily if needed for additional support. Though relief will be noted immediately, continued use may be needed to achieve maximum effects.